Everybody hurts - What can physical health professionals learn about how mental health professionals support their own emotional resilience and mental health?

The physical aspects of ultrasonography, difficult posture with prolonged pressure exertion, have been extensively researched and addressed with advances in machine ergonomics, operator awareness of posture and positioning and workplace tools to identify musculoskeletal problems. The mental stresses are less well recognized and have only recently started getting investigated. Ultrasonography is a mentally challenging activity requiring long periods of intense concentration, empathy and communication of complex and often difficult information to patients and clinicians, all of which carries an emotional toll. Practitioners are also under increasing time and caseload pressures exacerbated by COVID recovery and chronic fatigue from two years of pandemic. A survey of UK obstetric sonographers showed 92.1% and 91.0% met the burnout thresholds for exhaustion and disengagement, respectively).1 While many Trusts provide training to support physical health, few radiology departments educate their staff on emotional resilience or offer regular support to either promote or maintain mental wellbeing. Training, when available, is often focused on the receiver and not on the impact of vicarious traumas experienced as a result of repeatedly discovering/delivering difficult outcomes to patients on a regular and prolonged basis. Few health professionals are face-to-face with their patient at point of significant discovery whether that information is imparted to the patient or not. Mental health professionals have adopted a traumainformed stance into their working practices. This has not only informed the direct clinical work with patients but is also evident in the way the workforce is supported by the trust. Regular supervision, reflective practice and debriefs are required and monitored by the trust, based on research in clinical psychology to inform best practice. Some of these practices could be applied to physical health professionals to address some of the emotional burdens experienced as part of day-to-day delivery of care.

"Solidarity and community on our terms and through our lens": Community care and shared trauma for transgender and nonbinary peer supporters during the COVID-19 pandemic

Community support is an essential resource for psychological wellbeing among transgender and nonbinary communities. As the COVID-19 pandemic draws on, the role of community support in managing mental health concerns and the effects of structural inequity becomes increasingly important, yet few studies have focused on this dynamic. The present study examined how six transgender and nonbinary peer supporters understood the COVID-19 pandemic as a unique community crisis through their roles as helping professionals from a reflexive, thematic qualitative approach. The analysis resulted in 4 themes with 13 subthemes: (a) COVID pandemic as a trans-specific crisis;(b) shared membership;(c) healing role of community care;and (d) long-term impacts. Results show how transgender and nonbinary peer supporters undergo complex processes of vicarious traumatization and posttraumatic growth while engaging in peer support with community members, as well as how the COVID-19 pandemic has evolved as a crisis with unique implications for transgender and nonbinary groups. Findings provide evidence for the need to consider how post-traumatic sequelae develop in response to oppressive experiences, particularly that of gendered-racial marginalization within transgender and nonbinary communities of color, and how post-traumatic processes (i.e., responses to vicarious traumatization, post-traumatic growth) evolve among transgender and nonbinary communities. Implications on how to respond to community care and trauma during the COVID-19 pandemic within trans and nonbinary communities are provided: advocating for additional resources;building awareness around trauma processes;attending to clinical issues stemming from intersectional oppression. (PsycInfo Database Record (c) 2023 APA, all rights reserved) Impact Statement This study suggests that transgender and nonbinary individuals who provide emotional support for community members undergo processes of vicarious traumatization and post-traumatic growth. Additionally, the results highlight how the COVID-19 pandemic has evolved as a crisis with unique implications for transgender and nonbinary groups. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Ensuring an Attuned Workforce: Individual and Systemic Factors Impacting Trauma Professionals

While vicarious trauma from hearing traumatic material when working with clients has long been recognised, the concept that much vicarious trauma stems from systemic challenges, and work conditions, is a more recent development. There has been a willingness to recognise the toll on individuals of client stories, however this has allowed organisations to minimise other aspects of the work that are also impactful. Never has this been truer than in the last two years with the Covid-19 pandemic, when workers have experienced their own sense of risk at work, alongside a sense of possible expendability from their organisations. Workers may have felt obliged to keep meeting client need, whilst managing their own personal distress or worry. The article explores areas that contribute to vicarious, work-related trauma, other than hearing the narratives of those who have experienced trauma themselves. Individual and organisational practices, such as organisational culture;variability of the workload;conditions of the work environment;access to professional development;and the provision of quality supervision. The impact of each will be considered, with the aim not just to avoid vicarious trauma or burnout, but to proactively address issues that may impair the functioning of an integrated and fully cognisant professional.

Supporting survivors of institutional child sexual abuse during the COVID‐19 pandemic: A qualitative study of not‐for‐profit community and legal organisations in Greater Western Sydney

Before, during and since the Australian Royal Commission into Institutional Responses to Child Sexual Abuse (2013–2017), not‐for‐profit community and legal services have been critical in supporting survivors of institutional child sexual abuse. This qualitative study aimed to explore the perspectives of community and legal service practitioners operating in Greater Western Sydney regarding the ongoing impact of the COVID‐19 pandemic on the service system for survivors of institutional child sexual abuse. Semistructured interviews were conducted with 21 practitioners at 15 community and legal services. Through thematic analysis, the study identified five areas of concern regarding service provision and COVID‐19, including difficulties in navigating shifts to remote service delivery;changes in service accessibility;complications in accessing the National Redress Scheme;safety challenges for clients;and safety challenges for practitioners. The research identified a need for services to finesse frameworks that ensure remote services can be delivered safely for clients and practitioners alike. Priorities include adequate funding for technology and infrastructure, supporting survivors of abuse perpetrated online and encouraging effective coping strategies for practitioners who undertake trauma support work from home. Future research should consider how shifts to remote service delivery have impacted survivors of different demographic groups and the survivor support workforce. [ FROM AUTHOR] Copyright of Australian Journal of Social Issues (John Wiley & Sons, Inc. ) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Addressing Vicarious Trauma and Emotional Stress Among Medical Interpreters Through Care, Partnership and Respect

Interpreting palliative care conversations can be stressful due to the emotions and complex terminology involved, as well as the emphasis on fostering patient autonomy and disclosing prognosis transparently. To improve the quality of care for patients speaking different languages, a palliative care physician and social worker approached the director of interpreter services offering to provide sessions to address vicarious trauma. With interpreter input, they developed a series of monthly Dialogues in Palliative Care. This paper recounts how this supportive educational endeavor became a holistic approach to medical interpreters' occupational safety and health. The relationship between the clinicians and interpreters enabled a smooth transition to weekly emotional support for the interpreters and the modeling of a culture of care during the Covid-19 pandemic. Interpreters are integral members of the health care team and are uniquely vulnerable to emotional stress. They deserve a work environment that mitigates vicarious trauma. © 2022 International Association of Translation and Intercultural Studies. All rights reserved.

Positive effects of trauma work: Vicarious resilience of child abuse crisis counselors before and during the COVID-19 pandemic

Hotline crisis counselors witness trauma in others, leaving them vulnerable to compassion fatigue and burnout. Vicarious resilience can counterbalance the harmful effects of trauma work and help individuals avoid vicarious traumatization. This dissertation examined four research questions constructed to explore the lived experiences of child abuse hotline crisis counselors over thirty-six months, both before and during the COVID-pandemic. Furthermore, the recent implementation of text and chat, in addition to a traditional phone call, has ushered in new issues of abuse and concern brought on by the pandemic (i.e., isolation, fear of sickness and death, employment, housing and childcare insecurities, school closures, remote work, divisive custody issues related to masks and vaccines). Using a phenomenological methodology, this study draws upon three years of focus group data (2019, 2020, & 2021). Six focus groups were conducted with twenty-six hotline counselors over the three years to address the research questions that explore the counselors' professional experiences before and during the pandemic. Analysis of the focus group transcriptions included a single-year analysis that looked at each year and a cross-year analysis to look at themes generated by analyzing all years together. Themes of resilience, workspace, and healing found that the hotline counselors shared positive experiences and personal growth from their work with implications of advocating for self-care not as an individual issue but as a larger collective issue among counselors. The results of this study will advance the concept of vicarious resilience, trauma-informed practices, and, most importantly, sustaining, and empowering helping professionals in challenging times. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

[Covid-19 caregivers, psychotraumatized superheroes]. / Soignants de la Covid-19, de super-héros à psychotraumatisés.

The Covid-19 pandemic has taken its toll on health care teams faced with deaths and hospital overcrowding. Some caregivers suffered from vicarious trauma. Analyzing the impact of this trauma, its inclusion in a context of tension, fatigue and increased lassitude, is imperative in order to propose adjusted care. Eye Movement Desensitization and Reprocessing therapy seems to have a relevant place in this context.

Ensuring an attuned workforce: Individual and systemic factors impacting trauma professionals

While vicarious trauma from hearing traumatic material when working with clients has long been recognised, the concept that much vicarious trauma stems from systemic challenges, and work conditions, is a more recent development. There has been a willingness to recognise the toll on individuals of client stories, however this has allowed organisations to minimise other aspects of the work that are also impactful. Never has this been truer than in the last two years with the Covid-19 pandemic, when workers have experienced their own sense of risk at work, alongside a sense of possible expendability from their organisations. Workers may have felt obliged to keep meeting client need, whilst managing their own personal distress or worry. The article explores areas that contribute to vicarious, work-related trauma, other than hearing the narratives of those who have experienced trauma themselves. Individual and organisational practices, such as organisational culture;variability of the workload;conditions of the work environment;access to professional development;and the provision of quality supervision. The impact of each will be considered, with the aim not just to avoid vicarious trauma or burnout, but to proactively address issues that may impair the functioning of an integrated and fully cognisant professional. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Positive effects of trauma work: Vicarious resilience of child abuse crisis counselors before and during the COVID-19 pandemic

Hotline crisis counselors witness trauma in others, leaving them vulnerable to compassion fatigue and burnout. Vicarious resilience can counterbalance the harmful effects of trauma work and help individuals avoid vicarious traumatization. This dissertation examined four research questions constructed to explore the lived experiences of child abuse hotline crisis counselors over thirty-six months, both before and during the COVID-pandemic. Furthermore, the recent implementation of text and chat, in addition to a traditional phone call, has ushered in new issues of abuse and concern brought on by the pandemic (i.e., isolation, fear of sickness and death, employment, housing and childcare insecurities, school closures, remote work, divisive custody issues related to masks and vaccines). Using a phenomenological methodology, this study draws upon three years of focus group data (2019, 2020, & 2021). Six focus groups were conducted with twenty-six hotline counselors over the three years to address the research questions that explore the counselors' professional experiences before and during the pandemic. Analysis of the focus group transcriptions included a single-year analysis that looked at each year and a cross-year analysis to look at themes generated by analyzing all years together. Themes of resilience, workspace, and healing found that the hotline counselors shared positive experiences and personal growth from their work with implications of advocating for self-care not as an individual issue but as a larger collective issue among counselors. The results of this study will advance the concept of vicarious resilience, trauma-informed practices, and, most importantly, sustaining, and empowering helping professionals in challenging times. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

CONSULTATION-LIAISON PSYCHIATRY RESPONSE TO THE IMPACT OF BUSHFIRES, VOLCANOS AND COVID-19 ON A STATE-WIDE BURN CENTRE

Background: The Statewide Burns Unit (SWBU) at Royal North Shore Hospital, one of two burns units in NSW, is a 12-bed unit run under the plastics/burns surgical team, nurse unit manager and multidisciplinary allied health team. Consultation-liaison (CL) psychiatry provides a part-time CL psychiatry registrar supervised by a parttime CL psychiatrist, who see and assess all admissions for pre-morbid and/or new and emerging acute mental health (MH) issues. Over 2019-2021 the SWBU saw significant numbers of burn injury patients because of several natural disasters and a spike in self-immolation during Sydney's COVID-19 lockdowns. The traumatic nature of the injuries was challenging for staff to manage over such a prolonged period. Senior team members were aware of the urgent need to (1) increase support for staff to minimise burnout risk and (2) improve access to longer-term psychological treatments for patients after discharge. Objectives: To report on the MH issues managed during this time, the management challenges and the process of significant service development, aiming to address unmet patient need as well as staffing, burnout and vicarious trauma. Methods: Naturalistic file review and NSW Statewide Burns registrar review supplemented by data from interviews with SWBU multidisciplinary team staff members. Conclusion: Trauma-informed and relational care is at the heart of the SWBU multidisciplinary team approach to care, requiring high-level service support and funding. CL psychiatry services can have a significant role in promoting service development, which sits under CanMEDS hats of clinical expert, advocate and leader.

COVID-19 News and Its Association With the Mental Health of Sexual and Gender Minority Adults: Cross-sectional Study.

BACKGROUND: Sexual and gender minority (SGM; people whose sexual orientation is not heterosexual or whose gender identity varies from what is traditionally associated with the sex assigned to them at birth) people experience high rates of trauma and substantial disparities in anxiety and posttraumatic stress disorder (PTSD). Exposure to traumatic stressors such as news related to COVID-19 may be associated with symptoms of anxiety and PTSD. OBJECTIVE: This study aims to evaluate the relationship of COVID-19 news exposure with anxiety and PTSD symptoms in a sample of SGM adults in the United States. METHODS: Data were collected between March 23 and August 2, 2020, from The PRIDE Study, a national longitudinal cohort study of SGM people. Regression analyses were used to analyze the relationship between self-reported news exposure and symptoms of anxiety using the Generalized Anxiety Disorder-7 and symptoms of COVID-19-related PTSD using the Impact of Events Scale-Revised. RESULTS: Our sample included a total of 3079 SGM participants. Each unit increase in COVID-19-related news exposure was associated with greater anxiety symptoms (odds ratio 1.77, 95% CI 1.63-1.93; P<.001) and 1.93 greater odds of PTSD (95% CI 1.74-2.14; P<.001). CONCLUSIONS: Our study found that COVID-19 news exposure was positively associated with greater symptoms of anxiety and PTSD among SGM people. This supports previous literature in other populations where greater news exposure was associated with poorer mental health. Further research is needed to determine the direction of this relationship and to evaluate for differences among SGM subgroups with multiple marginalized identities.

Vicarious trauma in nursing professionals: A concept analysis.

AIM: To explore the concept of vicarious trauma (VT) and clarify its fundamental meaning and distinctiveness as a psychological phenomenon experienced by nurses. BACKGROUND: The current coronavirus disease 2019 (COVID-19) pandemic has incited significant psychological distress on nursing professionals worldwide. There is growing knowledge of the negative outcomes of this distress including the manifestation of nursing burnout syndrome, compassion fatigue, and vicarious traumatization (VT). These concepts have often been used interchangeably throughout nursing discourse creating confusion surrounding their uses and unique attributes. DESIGN: Walker and Avant's method of concept analysis. RESULTS: VT is a psychological phenomenon that causes a permanent cognitive shift in the inner experience and world views of nurses after prolonged empathetic engagement with a patient's trauma. VT manifests as physical and emotional symptoms of distress, which can disrupt a nurses ability to provide competent care. Contradictions within the literature exist when defining VT, burnout syndrome, and compassion fatigue, creating difficulty identifying attributes and consequences unique to VT. CONCLUSION: More empiric rigor is needed to adequately operationalize VT. Given the traumatic nature of the COVID-19 pandemic, immediate policy and education attention should be directed towards understanding the relationship between nurses working during the COVID-19 pandemic and the prevalence of VT.

You, me, and us: Exploring early career female psychologists' experience of trauma work

Early career female (ECF) psychologists represent an understudied group of psychologists despite their prevalence in the field. Newer clinicians who treat trauma, such as ECF psychologists, have been found to be at-risk for developing negative reactions to trauma work, such as vicarious trauma. However, less is known about the extent to which ECF trauma psychologists experience positive reactions to trauma work, such as vicarious resilience, and the ways in which intersectional identities impact vicarious responses and the therapeutic alliance. This study sought to address the following overarching research question: In their trauma work, how do ECF psychologists understand the ways in which their social identities and their clients' social identities influence the therapeutic alliance, outcomes, and their vicarious experiences? Using a social constructivist paradigm and qualitative narrative inquiry approach, twelve ECF psychologists with at least two years of trauma training participated in semi-structured interviews exploring their narratives of treating trauma victims and their reactions to their trauma work. Results were analyzed using a paradigmatic narrative approach, yielding three major themes of (a) Negotiating Self and Client Identities, (b) Vicarious Responses to Trauma Work, and (c) Working as an ECF Psychologist "In the Current Climate." Implications for training and future research are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

[Intervention of the medical-psychological emergency unit with the carers during Covid-19]. / Intervention de la cellule d'urgence médico-psychologique auprès des soignants pendant la Covid-19.

The medical-psychological emergency units have been meeting with care teams to discuss their experiences and feelings about Covid-19 for a little over a year. This preventive approach allows for psycho-education and the identification of stressful states.

Infodemic vs. Pandemic Factors Associated to Public Anxiety in the Early Stage of the COVID-19 Outbreak: A Cross-Sectional Study in China.

Introduction: Every outbreak of an epidemic or pandemic disease is accompanied by the tsunami of information, which is also known as the infodemic. Infodemic makes it hard for people to find trustworthy sources and reliable guidance when they need it, and causes social panic about health, widens the gaps between races and regions, and even brings the social chaos all over the world. While most researchers and related parties made efforts to control the inaccurate information spreading online during the COVID-19 pandemic, the infodemic influence caused by the overload of accurate information were almost or completely ignored, and this will hinder the control of infodemic in future public health crises. This study aims to explore the infodemic vs. pandemic influence on people's psychological anxiety across different media sources in the early stage of the COVID-19 outbreak in China. Methods: A cross-sectional study using online survey method was conducted by a data-collection service provider in April 2020. A total of 1,117 valid samples were finally collected from 5,203 randomly invited members via webpages and WeChat. The sample distribution covered the 30 provincial administrative divisions of mainland China. Results: Hierarchical regression analysis for the potential pandemic sources and infodemic sources of psychological anxiety showed that the infodemic factors of attention to the coronavirus information (ß = 0.154, p < 0.001) and commercial media exposure (ß = 0.147, p < 0.001) is positively related to the level of anxiety. Statistics indicated that influence of the infodemic factors is over and above that of the pandemic factors (ΔR2 = 0.054, F = 14.199, and p < 0.001). Mediation analysis showed that information overload (B = 0.155, Boot SE = 0.022, and 95% Boot CI [0.112, 0.198]) mediates the link between attention to coronavirus information and anxiety; both information overload (B = 0.035, Boot SE = 0.014, and 95% Boot CI [0.009, 0.062]) and media vicarious traumatization (B = 0.106, Boot SE = 0.017, and 95% Boot CI [0.072, 0.140]) mediate the link between commercial media exposure and anxiety. Conclusion: This study suggested that the influence of infodemic with mixed accurate and inaccurate information on public anxiety does exist, which could possibly go beyond that of the pandemic. Information overload and vicarious traumatization explain how infodemic may be associated to public anxiety. Finally, commercial media could be a major source of infodemic in the Chinese media context. Implications for the related parties were discussed.

What Do Therapist Defense Mechanisms Have to Do With Their Experience of Professional Self-Doubt and Vicarious Trauma During the COVID-19 Pandemic?

This is the first study to examine psychotherapists' levels of defense mechanisms, their concurrent relationship with professional work-related stress (professional self-doubt and vicarious trauma), and how their levels of defense mechanisms predict the changes in these professional stresses over the course of 3 months since the start of the COVID-19 pandemic. Data from two online studies (Study 1; N = 105 and Study 2; N = 336), using two self-report measures of therapists' defense mechanisms (Defense Style Questionnaire-40 in Study 1 and Defense Mechanism Rating Scales Self-Report-30 in Study 2), are presented. Therapists reported higher levels of mature defense mechanisms, and lower levels of immature defense mechanisms, compared to published community and clinical populations assessed before and during the pandemic. Therapists' lower level of mature defense mechanisms and higher levels of neurotic and immature defense mechanisms were related to higher concurrent levels of vicarious trauma and professional doubt. Therapists who reported higher levels of mature defense mechanisms at 3-month follow-up showed less vicarious trauma and professional self-doubt at follow-up, after controlling for these professional stressors at baseline. Implications for clinical supervision and training are discussed. The context and professional challenges during the pandemic are unique and future replications of the results outside the pandemic context are warranted.

Association of Social Media Use With Mental Health Conditions of Nonpatients During the COVID-19 Outbreak: Insights from a National Survey Study.

BACKGROUND: Considerable research has been devoted to examining the mental health conditions of patients with COVID-19 and medical staff attending to these patients during the COVID-19 pandemic. However, there are few insights concerning how the pandemic may take a toll on the mental health of the general population, and especially of nonpatients (ie, individuals who have not contracted COVID-19). OBJECTIVE: This study aimed to investigate the association between social media use and mental health conditions in the general population based on a national representative sample during the peak of the COVID-19 outbreak in China. METHODS: We formed a national representative sample (N=2185) comprising participants from 30 provinces across China, who were the first to experience the COVID-19 outbreak in the world. We administered a web-based survey to these participants to analyze social media use, health information support received via social media, and possible psychiatric disorders, including secondary traumatic stress (STS) and vicarious trauma (VT). RESULTS: Social media use did not cause mental health issues, but it mediated the levels of traumatic emotions among nonpatients. Participants received health information support via social media, but excessive social media use led to elevated levels of stress (ß=.175; P<.001), anxiety (ß=.224; P<.001), depression (ß=.201; P<.001), STS (ß=.307; P<.001), and VT (ß=.688; P<.001). Geographic location (or geolocation) and lockdown conditions also contributed to more instances of traumatic disorders. Participants living in big cities were more stressed than those living in rural areas (P=.02). Furthermore, participants from small cities or towns were more anxious (P=.01), stressed (P<.001), and depressed (P=.008) than those from rural areas. Obtaining more informational support (ß=.165; P<.001) and emotional support (ß=.144; P<.001) via social media increased their VT levels. Peer support received via social media increased both VT (ß=.332; P<.001) and STS (ß=.130; P<.001) levels. Moreover, geolocation moderated the relationships between emotional support on social media and VT (F2=3.549; P=.029) and the association between peer support and STS (F2=5.059; P=.006). Geolocation also interacted with health information support in predicting STS (F2=5.093; P=.006). CONCLUSIONS: COVID-19 has taken a severe toll on the mental health of the general population, including individuals who have no history of psychiatric disorders or coronavirus infection. This study contributes to the literature by establishing the association between social media use and psychiatric disorders among the general public during the COVID-19 outbreak. The study findings suggest that the causes of such psychiatric disorders are complex and multifactorial, and social media use is a potential factor. The findings also highlight the experiences of people in China and can help global citizens and health policymakers to mitigate the effects of psychiatric disorders during this and other public health crises, which should be regarded as a key component of a global pandemic response.